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Wis. Republicans Vote to Reject Medicaid Expansion

MADISON, Wis. (AP) - The Republican-controlled budget committee on Tuesday sided with Gov. Scott Walker in voting to reject a federally funded expansion of Wisconsin's BadgerCare Medicaid program even though accepting the money would lead to more people receiving insurance at a cheaper cost to the state.

Republicans on the Joint Finance Committee said they agreed with Walker that there was no certainty the federal government would follow through with its commitment to pay for the expanded coverage in future years. They said their plan protected taxpayers and strengthens the state's safety net.

"These reforms strengthen Wisconsin's safety net for those in need, while protecting our taxpayers from unnecessary risk and the fiscal uncertainty coming out of Washington, D.C.," Walker said in a statement.

Democrats called the vote callous, saying it didn't make sense not to accept federal money and cover more people.

"There is no good reason that we would say no to this," said Democratic Rep. Cory Mason of Racine.

Medicaid was one of the few remaining issues for the budget committee to decide as it worked Tuesday to finish voting on Walker's budget. Other topics slated to be taken up Tuesday include public school funding, private school voucher expansion and income tax cuts.

Once passed by the committee, the budget will head to the Assembly and Senate for debate later this month. Republicans have a 60-39 majority in the Assembly and an 18-15 edge in the Senate.

Debate on the Medicaid proposal was interrupted periodically by protesters in the packed meeting room, some of whom shouted at Republicans as police led them out of the room.

Walker's Medicaid plan limits eligibility to people who earn less than 100 percent of the federal poverty rate, down from 200 percent currently.

Walker assumed that 93 percent of the people who would lose BadgerCare coverage would still buy insurance through the new federal health insurance marketplaces known as exchanges. But the nonpartisan Legislative Fiscal Bureau said that estimate was "unreasonably optimistic."

"What the governor is doing is providing access to health care for people who need help," said Republican Sen. Albert Darling, the committee's co-chair.

To access the federal money, the state would have had to offer Medicaid to people who earn up to 138 percent of poverty, or about $15,000 for a single person. To qualify under the plan as approved by the committee, a person couldn't earn more than about $11,500 a year.

Accepting the federal money would result in an additional 84,700 people being covered by Medicaid and cost $119 million less because of the federal money that would have come to the state. The committee voted to add $30 million over the next two years for Wisconsin hospitals, which will be matched with federal money, to help them pay for people who seek medical care but don't have insurance.

"You may be taking care of the hospitals, but you're not taking care of poor people," said Sen. Bob Wirch, D-Racine.

Republicans also added safeguards to make sure people who earn between 100 percent and 200 percent of poverty don't lose their current coverage next year if a federally certified health exchange is not ready by Oct. 15. Another protection would continue coverage for people earning up to 200 percent of poverty if they live in a county that doesn't have a qualified health insurance plan offered through an exchange operating there.

The committee also approved another part of the governor's budget that removes a cap on a program that provides coverage to childless adults. By doing that, an additional 82,700 people who earn less than 100 percent of poverty are estimated to get coverage who don't currently have it.

Dozens of Wisconsin health care groups, including those representing doctors, hospitals and nurses, had called for accepting the expansion. Health care advocates, Democrats and those who receive or hope to get the state's Medicaid BadgerCare benefits held a news conference prior to the committee vote urging acceptance of the expansion.

Teresa Torres of Milwaukee said at the news conference that she applied for the BadgerCare program in 2008 but was put on a waiting list. Torres said in March she was diagnosed with a rare blood disease and doesn't know how she will afford coverage she needs.

"This will affect my life and the rest of my life," she said of the decision whether to expand Medicaid. "If I don't get the treatment I need, I may not be here."

Twenty-four states have agreed to the expansion. Wisconsin is one of 15 states not planning on expanding, while another 11 have not yet made a decision.

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